International Statistical Classification

of Diseases and Related Health

Problem
Tenth Edition

Dr. H. Indra Z,Sp.THT-KL

Program Studi Pendidikan Dokter

Universitas Malikussaleh
WHAT IS CLINICAL CODING?

the translation of diseases, health

related problems and procedural
concepts from text to
alphabetical/numeric codes

for storage, retrieval and analysis

Why use a classification?
allows easy storage, retrieval and analysis
of data

allows standard comparisons of

data between hospitals, states,
provinces or countries

allows comparisons of data in the same

location across time
What is a Statistical Classification?

system of categories or groupings

codes assigned according to criteria

statistical classification - limited number of

mutually exclusive code categories; there is
not a unique code for every concept
 HISTORY
Sir George Knibbs (Australian Statistician) &
Francois Boussier de Lacroix (1706-1777)
dikenal sbg Sauvages dlm buku Nosologia
Methodica
Linnaeus (1707-1778) Genera Morborum
William Cullen (Edinburgh) pd 1785
menerbitkan Synopsis Nosologiae
Methodiceae
William Farr (1807-1883) from the General
Register Office of England and Wales: first
medical statistician use international
 History of the ICD
1900 - 1st Bertillons Classification of COD 179
categories
1910 - 2nd Bertillon continues revision
1920 - 3rd Bertillon revises, dies in 1922
1929 - 4th 1928 Mixed Commission created
expansion of 1920 rubrics
1938 - 5th Mixed Commission continues
development
1946 - 6th International WHO takes over
1955 - 7th Minor amendments only
1965 - 8th Radical revision structure unchanged
1975 - 9th 4th and 5th character detail
1992 - 10th Major restructuring and reorganisation
2007 ICD-11 work commences
Family of Classifications

ICD-10 is one of a group of classifications

used to capture information about health
status
Known as the World Health Organisation
Family of International Classifications (WHO-
FIC)
Chapters of the ICD-10
21 Chapters

Roman Numerals I XXII

Refer to Chapter number NOT code letter

Some chapters use multiple code letters
Some code letters are split between chapters
ICD 10 Chapters
21 chapters
1st character letter, each for a chapter except.
D both in chap. II, neoplasms & Chap III, diseases of
blood & blood forming organs & certain disorders involving
the immune mechanism
H-Chap VII diseases of the eye & adnexa, & chap. VIII,
diseases of the ear and mastoid process
Four chaps. Use more than one letter I, II, XIX, XX
I- XVII relate to disease & other morbid conditions
XVIII symptoms, signs, abnormal clinical & lab. Findings,
not elsewhere classified
XIX injuries, poisoning & certain other consequences of
external causes
Volumes of the ICD-10

Volume 1 Tabular List, the

alphanumeric
listing of diseases and
disease groups
Volume 2 Instructions and guidelines
Volume 3 Alphabetical index,
comprehensive listing of all
conditions in the Tabular list
ICD 10 : COMPOSITION OF CHAPTERS

Chapter number an designation Range of codes

A00-B99
I Certain infectious and parasitic diseases
C00-D48
II Neoplasms
III Disease of the blood and blood forming
organs and certain disorders involving
the immune mechanism D50-D89
IV Endocrine, nutritional and metabolic
diseases E00-E90
V Mental and behavioural disorders
F00-F99
VI Diseases of the nervous system
G00-G99
VII Diseases of the eye and adnexa
H00-H59
VIII Diseases of the ear and mastoid
H60-H95
process
I00-I99
IX Diseases of the circulatory system
J00-J99
X Diseases of the respiratory system
ICD 10 : COMPOSITION OF CHAPTERS

Chapter number an designation Range of codes

XI Diseases of the digestive system K00-K93
XII Disease of the skin and subcutaneous L00-L99
tissue
M00-M99
XIII Diseases of the musculo-skeletal system
and connective tissue
XIV Disease of the genito-urinary system N00-N99
XV Pregnancy, childbirth and the puerperium O00-O99
XVI Certain conditions originating in the P00-P95
perinatal period
XVII Congenital malformations, deformations, Q00-Q99
and chromosomal abnormalities
ICD 10 : COMPOSITION OF CHAPTERS

Chapter number and Range of codes

designation R00-R99
XVIII Symptoms, signs and abnormal
clinical and laboratory findings, not
elsewhere classified

XIX Injury, poisoning and certain other S00-T98

consequences of external causes

XX External causes of morbidity and V01-Y98

mortality

XXI Factors influencing health status and Z00-Z98

contact with health services
CHAPTER XXI FACTORS INFLUENCING HEALTH
STATUS AND CONTACT WITH HEALTH SERVICES
Persons with potential health hazards related to
socio economic circumstances (Z55-Z65)
Z55 Problems related to education and literacy
Z55.3 Under achievement in school
Z56 Problems related to employment and
unemployment
Z56.2 Threat of job loss
Z60 Problems related to social environment
Z60.3 Acculturation difficulty
Z65 Problems related to other psychological
circumstances
Z65.4 Victim of crime and terrorism (Includes
victim of torture)
 Structure of the core ICD-10 code

The structure of the core 3 character code is:

A37

first character followed by

A to Z 2 digits
 Structure of the ICD-10 code
The structure of the 4 character sub-categories is:

A37.1

first character followed by then a lastly another

A to Z 2 digits point digit
 Qualifiers on class level

Cologne, 19/25-October 2003 Meeting of Heads of WHO FIC CC 18

Multiple views on classes

Shows class in
the hierarchy

Cologne, 19/25-October 2003 Meeting of Heads of WHO FIC CC 19